Erectile dysfunction is a male disorder in which the penis of the body gets affected. In this issue, a male is unable to gain a proper and hard erection which is important for satisfactory intercourse. This sexual problem can prevail in the body of a person due to a number of physical, psychological, and relationship factors. The main problem that a person notices in this issue is a decline in the levels of sexual satisfaction not just in there but their partner’s body also.
Prevalence and Impact on Men’s Lives
According to a few studies that are published in the Journal of Sexual Medicine, the problem of erectile dysfunction happens in the body of more than 50% of the male population who lie in the age group of 40-70. Now erectile dysfunction is a problem that significantly impacts the life of a person. A person will notice low self-esteem, frustration, declining confidence and shame because of the issue.
Many people also report that they are unable to form a sexually intimate relationship due to these factors, which can further lead to anxiety and depression also. The frequency of sexual activity also decreases, due to which the relationship of a person also gets strained. Moreover, some males with erectile dysfunction are not even able to ejaculate properly, which has a direct impact on their fertility.
Importance of raising awareness and addressing misconceptions
In the past few years, we have seen a sudden increase in the number of erectile dysfunction. In the past eight years, the increase in erectile dysfunction cases is 27 times. It happens because people are not aware of the issue, and there are many misconceptions among people about the problem.
- Most men think that the problem is untreated, due to which they don’t want to open up with anyone regarding the problem. Such men should know that the problem is very common and curable. All you need to do is reach out to the expert, and they will help.
- Some people think that ED is a normal part of aging and will happen in the body. It is true that people with an increase in age are highly prone to the issue, but not applicable in all cases. With proper care of the body, even aged people can stop ED from happening, and the issue can also happen in the body of a person who is young.
- Most people ignore ED thinking that it is common, which is not true. The issue can be a symptom of some serious underlying problems like diabetes, depression, heart problems, etc. That is why it is important to visit the physician and get appropriate treatment for the problem.
Due to these misconceptions, it is very important to raise awareness about the issue. It will help in improving the quality of life of men, sexual health and relationships of a person.
Importance of a holistic approach to managing erectile dysfunction
If we see the pool of people who are suffering from erectile dysfunction issues, we will notice various causes. The problem happens in the body due to physical, neurological, psychological, emotional and various other reasons. That is why focusing on a single sort of solution for the issue is not sufficient. We need to focus on a holistic plan for managing erectile dysfunction in which, first of all, we consider scanning the body of a person and finding the reason first. After finding the reason, we will focus on making a treatment plan which not just addresses the problem of erectile dysfunction but also focuses on resolving the underlying causes.
Causes of Erectile Dysfunction
Erectile dysfunction is an issue that can happen solely in the body but can also appear as a side effect of an underlying issue. Here is the detail of the reasons why erectile dysfunction happens in the body of a person-
1) Physical factors
Following are the physical factors that might contribute to the erectile dysfunction issue in the body of a person.
We all know that the vascular functioning of our body is very important for gaining an erection and maintaining it. But there are a few problems with the vascular system due to which a person might experience erectile dysfunction.
It is a condition in which the arteries in our body become hard and narrow because of plaque buildup. Due to this, the blood flow towards the penis stops causing erectile dysfunction.
- High blood pressure
Males who are suffering from high blood pressure issues notice damage in the blood vessels. It happens because the vessels are unable to handle the high pressure of the blood. Damaged blood vessels are unable to carry blood properly, which causes erectile dysfunction.
- Venous leak
In the issue of venous leak, blood reaches inside the penis during arousal but flows/ leaks before a person gains a proper hard erection. Due to this leakage, people find it really difficult to achieve and maintain an erection which is a symptom of erectile dysfunction.
We know for a fact that our nervous system also plays a very big role in achieving an erection. Whenever we are sexually aroused, our brain sends a signal to the penis to dilate the vessels, which causes an erection. But there are a few neurological problems that can cause erectile dysfunction problems indirectly.
- Parkinson’s disease
Parkinson’s disease is a problem in which the brain of a person is unable to control the muscles inside the body. The issue can interfere with the ability of a brain to send signals to the penis for erection. This can lead to softer or no erection which means erectile dysfunction issues.
- Multiple sclerosis
Multiple sclerosis is a situation in which the central nervous system, CNS, of our body, gets affected. This leads to damaging the nerves that carry signals to the penis for erection. Due to this, a person is unable to gain an erection.
Stroke is an issue in which the blood supply to the brain gets interrupted. Due to this, parts of the brain that controls the erection get damaged, which causes erectile dysfunction.
- Spinal cord injuries
The spinal cord is a part of the spine of a person which contains a bundle of nerves and cells. They carry messages from brain to body. If there is an injury in the spinal cord, then the whole messaging system of the body gets impacted, including the signals of erection. Due to this, a person does not gain an erection and suffers from erectile dysfunction.
There are a bunch of hormones like testosterone and androgen, which plays a very crucial role in the sexual life of a person. The imbalance of such hormones can lead to erectile dysfunction in your body. The following are the reasons why ED happens in your body.
- Low testosterone
Testosterone is the primary male sex hormone which is responsible for almost 80% of the functions. If the levels of testosterone are low in your body, you will not gain an erection and will have a very low sex drive. This leads to the issue of erectile dysfunction.
It is an issue in which the thyroid gland starts producing too much hormone, which affects the levels of testosterone. Due to this, you will notice the erectile dysfunction issue.
In the case of hypothyroidism, the thyroid gland produces less amount of thyroid hormone, which also impacts testosterone levels hence causing erectile dysfunction.
Medication side effects
There are some medicines also which can cause erectile dysfunction as a side effect. Here is a list of medicines and reasons why it causes erectile dysfunction.
The use of antidepressants is going to slow the ability of the brain. Due to this, the brain is unable to send signals to the penis to cause an erection which causes erectile dysfunction.
Antihypertensives is a group of medicine that helps in reducing the flow of blood in the body to treat high blood pressure issue. Due to this, blood flow to the penis also decreases, which produces a softer erection hence erectile dysfunction.
Antihistamines are a group of medicines that interfere with the nerves inside the body. It also has antiandrogen properties, due to which the testosterone levels in the body decrease. Due to this, a person starts noticing erectile dysfunction.
- Prostate cancer medications
Prostate cancer medicines cause erectile dysfunction as a side effect of the medicine.
Chronic diseases cause erectile dysfunction in the body of a person as they interfere with the blood flow in the body or damage the nerves. Here is a list of issues that might cause erectile dysfunction as a symptom.
A person who has a diabetes issue will notice damage in nerves and blood vessels. Due to this, neither blood is able to flow to the penis, nor the brain sends out proper signals for erection. Due to this, a person starts noticing erectile dysfunction.
- Kidney disease
People who have kidney issues will notice a problem in the blood flow inside the body. Due to this, the penis does not get enough blood to gain an erection, due to which erectile dysfunction happens.
- Liver disease
People who have liver problems notice an interference in their hormone metabolism. In this, the hormones important for the sexual function of a person get affected, which causes erectile dysfunction in the body.
In Peyronie’s disease, a scar starts forming inside the penis, which results in the curving of the penis. Due to this, sexual intercourse becomes difficult and painful. Due to the scar, blood does not fill up properly in the penis, and erectile dysfunction happens.
Substance abuse and alcoholism
A person who is consuming excessive alcohol will notice damage to their blood vessels and nerves. The whole system of causing an erection gets impaired, leading to erectile dysfunction in the body. Moreover, alcohol can also lead to a decrease in testosterone levels. The same is the case with substance abuse, as it also damages nerves and blood vessels.
2) Psychological factors
Stress and anxiety
Stress and anxiety are one of the biggest contributors to the erectile dysfunction issue. Different kinds of stress that can easily cause erectile dysfunction in your body are-
- Work-related stress
We have very commonly seen that nowadays people are very busy with their work life. They are unable to manage their time properly and even have high-level stress due to competition and performance pressure. Due to work stress, you will notice that your sexual desire is decreasing, due to which you will not gain an erection properly. This stress can also cause fatigue, disturbance in sleeping patterns and hormonal imbalance, which directly leads to erectile dysfunction.
- Financial stress
Financial stress is a very big issue that many people notice nowadays. More than 65% of males have admitted openly that finances and lack of money are a source of their stress, as per the American Psychological Association. Due to stress, you will find it really difficult to gain an erection because your mind is unable to focus on arousal. Moreover, financial stress in the life of a person can also lead to problems in the personal lives and relationships of a person.
- Relationship stress
Stress and problems in the relationship of a person can also lead to erectile dysfunction. There are many reasons, like lack of emotional connection, communication, unresolved matters, infidelity, etc., that can cause stress in a relationship. Due to this, a person is unable to get aroused properly and starts facing the issue of erectile dysfunction.
Depression is becoming a leading reason behind erectile dysfunction. According to the reports, men who have depression have two times more chances of developing erectile dysfunction. When a person is suffering from depression, they will notice that they lack interest in sex and the brain is not releasing chemicals that are important for regulating sexual arousal. Also, a person is unable to focus properly on sexual activity when their mind is busy with various thoughts.
Sometimes overthinking about performance can lead to erectile dysfunction. This problem especially happens in the bodies of younger men. Most of the time, a person who is having intercourse for the first time has this feeling, and when they are not able to perform well, their performance anxiety increases. Now anxiety leads to various problems we have discussed in the above section, which leads to erectile dysfunction.
Negative body image
People who have a negative image of their body leads to stress and anxiety. It happens with people who don’t like the way their body looks and start feeling self-conscious when having intercourse. Due to this stress, a person is unable to gain an erection and notices erectile dysfunction issues.
3) Lifestyle factors
Lifestyle changes are becoming one of the biggest causes of erectile dysfunction because of lifestyle choices that people are making. Here are a few examples of lifestyle choices that might cause erectile dysfunction.
People who are living a sedentary lifestyle and don’t perform any physical activity also suffer from erectile dysfunction. It happens because no physical activity leads to obesity in the body of a person. Due to this heart of a person is at risk, which triggers the release of PDE type5. It attaches to the blood vessels and narrows them down, leading to softer erections and erectile dysfunction.
- High-fat diet
People who are consuming a high-fat diet notice an increase in cholesterol levels in their bodies. This cholesterol will accumulate in the blood vessels of a person, which narrows them down. Due to this, blood is unable to reach the penis in adequate amounts, which causes a softer erection.
- Excess sugar intake
If a person is consuming high amounts of sugar in their diet, they might notice various issues like obesity, diabetes and other health issues. These issues cause erectile dysfunction directly in the body of a male.
- Smoking can lead to damaging the blood vessels, due to which the penis does not get enough blood. The erection will be softer, which can be unsatisfying for intercourse.
- If you are smoking regularly, you will notice a decrease in the oxygen supply in the blood and penis. Due to this, the blood vessels get damaged, causing erectile dysfunction.
- Smoking can decrease hormone synthesis and testosterone levels, which can reduce sex drive and cause erectile dysfunction.
- Smoking can also damage the nerves of the body, which can lead to erectile dysfunction.
Obesity is a very complex problem that comes with a set of health hazards. Some of the problems that happen due to obesity in the body are-
- Hormone production in the body gets imbalanced, especially testosterone, due to which a person notices erectile dysfunction.
- Obesity also causes major vascular issues because the fat cells produce inflammatory chemicals. They are going to damage the blood vessels, which causes erectile dysfunction in return.
- Obesity can also cause problems like low self-esteem, anxiety and depression, which is also going to cause ED, as we have discussed above.
- There is a risk of type 2 diabetes in obesity due to which a person notices neuropathy. Due to this, the brain loses control of blood flow leading to erectile dysfunction.
Symptoms and Diagnosis
1) Identifying symptoms
Whenever you visit your physician and report the issue of erectile dysfunction, the physician is going to check for the symptoms. After checking the symptoms of the issue, they are going to run the diagnosis for erectile dysfunction. Below mentioned are the symptoms of the issue that you might experience.
Difficulty achieving an erection
- Softer erections or inability to achieve erections at all
People who are suffering from erectile dysfunction issues notice problems in achieving an erection. It happens because blood is unable to reach the penis for one reason or another. Now there are two situations here. The first situation is that a person gains an erection which is very soft. And in the second situation, a person does not get an erection at all.
- Inconsistency in achieving erections
In some cases, men with erectile dysfunction symptoms will notice inconsistent erections. It means that the erection of a person depends on various factors. Due to this, a person notices a normal erection on some days and softer or no erection at all on other days.
Difficulty maintaining an erection
People who have erectile dysfunction will notice the issue of maintaining an erection. In this case, a person is going to face problems when having intercourse. This leads to the problem of sexual dissatisfaction also in the body of a person
Reduced sexual desire
People who have erectile dysfunction issues in their bodies do not feel the desire to have sexual intercourse. It happens because when a person is unable to perform intercourse satisfactorily, they don’t want to do it. This problem is also known as a decrease in the libido levels.
2) Seeking professional help
We have discussed all the symptoms that happen in the body when a person is suffering from erectile dysfunction. If you notice any of the above issues, you must contact your physician as soon as possible. They will help you get rid of the issue in a professional way.
Importance of open communication
Whenever you visit the physician, one thing that you must keep in mind is to have open communication. You should share the details about the issue you have in your body with them in detail so that they can identify the reason for erectile dysfunction. Due to this, they are able to make a treatment plan for you that will work.
You must keep open communication in mind with your partner also. In many cases, stress in relationships can also cause ED. That is why you must talk to your partner, which can help you improve your situation.
Medical history and physical examination
Whenever you visit your physician, you must share your complete medical history with them. A medical history can help the physician identify any underlying issue which is causing erectile dysfunction. Along with that, the physician is also going to perform a physical exam to learn more details about the erectile dysfunction issue. Along with that, they are also going to ask you questions about your sexual life.
When you visit your physician, they will first check your body for the symptoms. After checking the symptoms and doing a physical examination, they are going to run diagnostic tests. With the help of tests, they are going to evaluate the reason why erectile dysfunction is happening inside your body. The list of tests includes the following-
The first option that a physician has to evaluate the situation of erectile dysfunction is blood tests. With the help of blood tests, the physician gets to know the following-
- Hormone levels
The blood tests are going to provide you with information about the levels of hormones inside your body. If the levels of the hormone (testosterone) in your body are high or low, it can be a cause of erectile dysfunction.
- Blood glucose levels
The blood tests are also going to provide you with reports about your blood glucose levels. If the blood glucose levels are high, then you are suffering from diabetes mellitus type 2. The problem of diabetes can be an underlying cause of the erectile dysfunction issue.
- Lipid profile
The blood test is also going to provide you with the details about your lipid profile. If the lipid levels in your body are high, it means you have high cholesterol levels in your body. Now cholesterol can be an underlying problem for erectile dysfunction in your body.
There is an option for urine tests, also that physicians have to diagnose the erectile dysfunction issue. The urine tests help the physician to identify any problem with the kidney or metabolism of the body. Now such problems can also cause erectile dysfunction in your body.
Nocturnal penile tumescence (NPT) test
The physician also performs a nocturnal penile tumescence test to diagnose erectile dysfunction. With the help of this test, the physician means the frequency and quality of erections that a person experiences during the night time. It is going to help your physician diagnose any physical issue which can be causing erectile dysfunction.
The physician also has the option to perform a penile ultrasound to diagnose the issue of erectile dysfunction. In this ultrasound, the physician is going to send sound waves inside your penis. It helps the physician to know the following problems-
- Assessing blood flow
- Identifying structural abnormalities
If a person has any of the above problems, like obstruction in blood flow or problems in the structure of the penis, he might experience erectile dysfunction.
Psychological evaluation is also a way to diagnose erectile dysfunction problems. The physician uses this way to diagnose erectile dysfunction that happens because of the issue of stress, anxiety, depression, problems in relationships, etc. The psychologist is going to evaluate the whole situation and then help you get out of the situation over a period of time through sessions.
After diagnosing the problem, the physician is going to draft the done for you treatment plan for you. Here are a few treatment options that a person has to get the upper hand over the erectile dysfunction issue. Let us discuss all of them in detail one by one.
1) Oral medications
The first option that a person has is consuming oral medications. First of all, a person should understand that oral medications like PDE type 5 help in treating ED issues that happen because of PDE type 5. It is an enzyme released by the body to contract the blood vessels. The main aim of PDE type 5 is to slow down the flow of blood to safeguard the heart. But this causes erectile dysfunction, which can be suppressed temporarily with the help of PDE type5 inhibitors medicine.
There are four major types of PDE type 5 inhibitors class action of medicine. The details about them have been discussed below-
- Sildenafil (Viagra)
Sildenafil is the active ingredient that was first used in the Viagra medicine by Pfizer. It was the first drug approved for use in the PDE type5 inhibitor category by the FDA in 1998. The medicine is going to block the PDE type 5 and increase nitric oxide production to dilate the smooth muscles of the blood vessel leading to dilation. It can lead to a harder erection which is great for the sexual satisfaction of a person. The medicine is only going to take 20-25 minutes on average to show its action. The results generated by the medicine will stay active for 5-6 hours. These timings can vary based on the levels of issues that a person has in their body.
- Tadalafil (Cialis)
Tadalafil is an active ingredient that was first used in the Cialis medicine by Lilly ICOS LLC. It was approved by the FDA for use in the year 2008. The medicine is different from Sildenafil because it stays active in the body of a person for up to 36 hours. To show such results, the ingredient only takes 40-50 minutes on average. The medicine is going to act in a similar way to Sildenafil citrate.
- Vardenafil (Levitra)
Vardenafil is a salt that was first used in Levitra medicine. The mechanism of action of the medicine is the same as the above two ingredients. The manufacturer of levitra is Bayer which is a German brand that was approved in the year 2003 by the FDA. The medicine will stay active inside your body for up to 5 hours and takes 40-50 minutes to act inside your body.
- Avanafil (Stendra)
Avanafil is an active ingredient that was first used by Vivus INC, and they branded it under the name of Stendra medicine. The medicine is going to last in your body for around 6 hours. The best part about the Avanafil medicine is that it only takes 15 minutes to show its action inside your body. The active ingredient was approved by the FDA in the year 2012.
The dose of all four active ingredients is decided by the physician based on the following information-
- They need to know about the levels of issues you have.
- They need to know about your body type and the response that medicine shows after acting inside your body.
- They need to know about your medical history and overall health status.
Note- There are two other PDE type 5 inhibitors present, which are Udenafil and Mirodenafil.
Potential side effects
Normal side effects
- Nasal congestion
- Back pain
- Muscle aches
- Visual disturbances such as changes in colour vision or blurred vision
- Increased sensitivity to light
- Urinary tract infections
- Respiratory infections
Rare side effects
- Priapism (prolonged erection)
- Sudden hearing loss or tinnitus (ringing in the ears)
- Cardiovascular events such as heart attack or stroke
- Low blood pressure
- Fainting or loss of consciousness
- Allergic reactions
2) Non-pharmacological treatments
Apart from oral medicinal treatments, there are some non-pharmacological ways to get rid of erectile dysfunction issues. These are options for people who don’t want to use oral medications or have allergies to the medicines. All of them have been listed below-
Vacuum erection devices
The vacuum erection device, or VED, is a hollow cylindrical device that helps in creating a vacuum around the penis. All you need to do is place the pump on your penis and start it. The pump is going to suck the blood inside your penis, which is going to provide a harder erection. Now you need to place a constriction ring at the base of your penis. Due to this, you are able to hold the erection for longer and enjoy your intercourse.
It is suggested to everyone that they should read the instructions about the medicine first and then use the device. One should also keep in mind that the VED is going to improve the situation temporarily. That is why you always need to use a pump before intercourse, like oral medications.
Potential side effects
- The use of a pump can cause pain in your penis because of the ring.
- You might not notice any ejaculation because of the use of vacuum erection devices.
- The pump can cause bruising and swelling in your penis.
- You will find it really difficult to achieve an orgasm when using the VED.
Penile implants are a method of treatment that is going to help patients get rid of erectile dysfunction permanently. In this method, physicians surgically place implants in your penis, which helps in achieving an erection. Here are two types of penile implants available in the market.
- Inflatable implants
Inflatable implants are the ones in which two cylinders are placed at the sides of the penis. In this, a pump is placed in the scrotum and a reservoir in the abdomen area. Whenever you are willing to have intercourse, you need to activate your pump. Now the fluid that is stored in the reservoir flows into the cylinders, which induces an erection. When you get your orgasm, you can use the pump to empty the cylinders. It is suggested that you first contact your physician and use the implant in front of them. This way, they will check whether you are using the pump correctly or not.
- Semi-rigid implants
It is the second type of implant in which two rods are placed at the sides of the penis. In this implant, you have to bend the penis upwards to achieve an erection. After you have your intercourse, you need to bend the penis downwards. Due to this, you will lose your erection. The semi-rigid implants are way easier to use as compared to inflatable implants and have less risk.
If we look at surgical procedures, then implementing semi-rigid implants is very easy in your body as compared to inflatable implants. You should visit your physician to know which one would be better for your body.
In intraurethral therapy, the physician is going to insert a medicated pallet inside your urethra. This pallet helps a person achieve an erection. In the case of intraurethral therapy, the physician is going to use MUSE, which is a medicated urethral system for erections. In this, Alprostadil medicine is present in a panel that is inserted in the urethra. The medicine dissolves in the walls of the urethra and surrounding tissues which leads to an erection.
Potential side effects
- Penile pain
- Burning or itching sensation in the urethra
- Discomfort or pressure in the penis or testicles
- Hematuria (blood in urine)
- Dizziness or lightheadedness
- Nasal congestion
- Hypotension (low blood pressure)
- Fainting or loss of consciousness
- Priapism (prolonged erection that lasts more than four hours)
- Urethral bleeding or spotting
- Urinary tract infections
- Allergic reactions to the medication or applicator
- Painful ejaculation
- Genital edema (swelling)
- Bruising or hematoma at the injection site
- Hypertension (high blood pressure)
- Tachycardia (rapid heartbeat)
- Palpitations (sensation of a racing heart)
Intracavernosal therapy is a way in which you need to inject medicine into your penis to achieve an erection. For intracavernosal therapy, Trimix medicine is used. It is a group of medicine that consists of three medications known as papaverine, phentolamine and alprostadil. Papaverine is a medicine that is going to relax the smooth muscles of blood vessels inside your penis.
This is going to make your penis dilate, which will create an erection. Phentolamine is an alpha-blocker that also helps in relaxing the smooth muscles of the urinary gland, prostate gland and penis. Due to this, more blood will flow inside your penis, which causes an erection. This medicine is present in Trimix to enhance the effects of papaverine. The third medicine, alprostadil, is a prostaglandin E1.
The main task of this medicine is to maintain the erection. It does so by keeping the blood vessels dilated and preventing blood from moving out of the penis. You must contact your physician about which method of application is good for your body. After that, you should use the medicine under the guidance and supervision of the healthcare provider. The results from the medicine will stay active for several hours. The Trimix is injected at the base or the sides of the penis.
Potential side effects
- Pain at the injection site
- Bleeding or bruising at the injection site
- Prolonged erection (priapism)
- Fibrosis (scarring) at the injection site
- Peyronie’s disease (abnormal curvature of the penis)
- Hypotension (low blood pressure)
- Dizziness or fainting
- Flushing or redness of the skin
- Allergic reactions or hypersensitivity
- Infection at the injection site
- Urinary tract infection
- Hematuria (blood in the urine)
- Difficulty urinating
- Urethral pain or burning
- Testicular pain or swelling
- Changes in vision or hearing
3) Psychological counselling
Psychological counselling is a very great method of getting over erectile dysfunction caused by stress, depression and anxiety. Following are the ways to get rid of psychological counselling.
Cognitive-behavioural therapy (CBT)
CBT, or cognitive-behavioural therapy, is a kind of counselling that helps men who have negative thoughts develop a certain kind of coping strategy. In the case of erectile dysfunction, the negative patterns can be preset beliefs about sexual performance, negative body image or thinking that you have less self-worth. Following are the steps that the psychologist is going to in cognitive behavioural therapy.
- Identifying negative thought patterns
When you visit your physician, the first task they are going to perform is to identify the negative pattern you have. They are going to ask you a bunch of questions that are going to help them figure out the patterns easily.
- Developing coping strategies
The next step is to develop strategies according to the patterns that a person has. For example, if a person has a negative body image and thinks that they are not worthy of having amazing intercourse, their libido will decrease. This will also impact their erection.
But the psychologist can help you build self-esteem as a coping strategy to get over that thought pattern. The process will take time, and you will notice results after a few weeks of counselling.
Sex therapy is a way in which the physician is going to help you address all the problems and concerns about your sexual life. People who are facing problems in intimacy and sexual functioning but don’t have physical problems can opt for this therapy. Following are the steps that your counsellor is going to take during the therapy.
- Addressing sexual concerns.
First of all, the counsellor is going to understand what are the sexual problems that are bothering you. The physician will have a list of the most common concerns that people have. Based on that, they will figure out what are your biggest concerns. The counsellor can also ask about your sexual history and relationship dynamics.
- Developing the solutions
After understanding your concerns, the therapist is going to design individual and couples sessions. In the sessions, they will help you with strategies and techniques that will help you get rid of the problem of erectile dysfunction. A list of techniques are-
- The physician is first going to educate you properly about the anatomy, response and physiology of sexual life. Some people don’t have the knowledge, due to which they face this problem.
- Communication skills are also a technique that includes expressing your desires, listening to each other, resolving any kind of tension, etc. Some people are shy and are unable to communicate properly, which causes erectile dysfunction.
- The therapist can also help you with sensate focus and behavioural exercises, which can resolve a lot of problems that people have. These include non-sexual touch, expression, focusing on pleasure, sexual satisfaction, arousal and mindful techniques.
All you need to do is work on the solution that your physician has provided to you and see results. But you need to be patient and consistent with the techniques and assignments that the therapist has provided to you.
Couples counselling is a concept of psychological counselling that helps couples who are going through some emotional or relational problems. Such conditions can lead to severe erectile dysfunction because problems in a relationship can cause a major decline in libido levels. There can be various problems like problems in a relationship, frustration, disappointment in your partner, blaming, unsatisfied sexual intimacy, etc.
In couple therapy, one needs to find a trained and experienced therapist who specializes in relationship psychology and sexual health matters. Both of you must go to the physician together or maybe alone in some cases when the physician asks you to. Therapists will help you identify the problem that you are going through and provide a solution to the couple. Following are the problems which the therapist is going to help a couple-
- Your therapist will help you improve the communication channel that you and your partner have. They know that communication is a very important key not just for personal life but for sexual relationships also. Through communication, you will be able to listen actively to your partner, express your needs and resolve conflicts also.
- The therapist is also going to help you explore alternative ways to express your intimacy other than just penetrative intercourse. Some of the forms can be massage, sensual touch and erotic play.
- They will also help in addressing any conflict in your relationship. There can be various problems that you might go through when in a relationship. The therapist addresses and resolves those problems.
- The therapist will help in improving the emotional connection that a couple have. In most cases, the therapist will suggest some bonding activities like sharing hobbies, planning date nights frequently and spending quality time with each other.
4) Lifestyle changes
We have commonly seen that the lifestyle changes that have happened in the life of a person in the past two decades are not healthy. Due to this, erectile dysfunction is happening very commonly in the lives of such people. But shifting our lifestyle towards a healthy one can really help in getting rid of erectile dysfunction permanently. Here are a few changes that a person should make.
Exercise is an essential part of a lifestyle if a person wants to stay healthy. Not doing much physical activity lately can cause a sedentary lifestyle which is a cause of erectile dysfunction. That is why the first change that a person should do in their lifestyle is to start doing exercise. It can help in improving the blood flow throughout the body, an important part of getting and maintaining an erection. Three different types of exercise you can do are-
- Aerobic exercises
Aerobic exercises are a group of exercises that helps in increasing your heart rate and breathing. These exercises help in improving erectile dysfunction by making your cardiovascular system healthy. A healthy cardiovascular system means better blood flow to the penis. You will notice the following benefits from aerobic exercise-
- Healthy blood vessels
- Decrease in inflammation
- Decreased risk of high blood pressure and diabetes.
Due to this, the risk of erectile dysfunction decreases, and you notice an improvement. Aerobic exercises that you can perform are jogging, cycling, swimming, sprinting, etc. According to a study, a person who performs aerobic exercises for 40 minutes 4-5 times a week for six months shows significant improvement in ED issues.
- Resistance training
Resistance training, commonly known as weight training, means working on your muscles against resistance produced by dumbbells, bands and machines. One should know that weight training helps in increasing the testosterone levels in your body. It is very important for healthy sexual functioning and an increase in libido. Along with that, weight training decreases body fat, increases muscle mass and reduces the risk of diabetes and high blood pressure.
You will notice that ED patients who engage in resistance training for 12-14 weeks show improvement in ED issues. But one should keep in mind that weight training requires proper knowledge and assistance. That is why one should not perform at home without proper guidance.
- Pelvic floor exercises (Kegel exercises)
The pelvic floor/ kegel exercise helps in providing strength to the pelvic muscles, which are actively involved in sexual activity. In this exercise, a person needs to contract and relax the floor muscles by controlling urine flow. A person can do this exercise anywhere and anytime. We suggest that a person should perform this exercise 2-3 times per day for best results. The exercise is going to provide strength and tone to muscles so that they can control the blood flow of the penis. Performing the exercise continuously for 2-3 months is going to decrease the erectile dysfunction levels in the body of a person.
We all know that obesity, high cholesterol, diabetes, etc., leads to erectile dysfunction. All these problems happen in the body of a person because of their unhealthy diet. Lately, human dependence on junk and processed food have increased manifolds, due to which erectile dysfunction has become very common. Here are a few changes that you can introduce in your diet and get over erectile dysfunction.
- Emphasis on fruits, vegetables, and whole grains
Increasing the number of fruits, vegetables and whole grains in your body will significantly reduce the risk of erectile dysfunction. It happens because these food items are rich in vitamins, minerals and antioxidants. These micronutrients are going to improve blood flow in the penis and also ensure better cardiovascular health. Items you should add to your diet are berries, nuts, leafy vegetables, oats and brown rice.
- Limiting saturated fats and added sugars
Saturated fats and added sugar in your diet can lead to inflammation, insulin resistance and high blood pressure. That is why you should exclude them from your diet. Most common examples will be red meat, butter, cheese, soft drinks, candies and pastries. Due to this, many underlying conditions causing ED, like diabetes, high blood pressure, etc., improve. You can replace them with high-protein and low-fat options which are unsaturated.
- Staying hydrated
Staying hydrated is very important for overall sexual health because dehydration can cause erectile dysfunction by decreasing blood volume. A person should drink at least eight glasses of water per day with some other hydrating beverages which are unsweetened. It will maintain a healthy blood volume and improve blood flow.
Smoking is a major reason why a person suffers from erectile dysfunction. A cigarette consists of nicotine and harmful chemicals which tend to damage the blood vessels in the body. Due to this, the blood flow to the penis decreases and starts noticing erectile dysfunction issues. That is why you must give up cigarettes or any other form of smoking as soon as possible, for which you have the following options.
- Nicotine replacement therapy
A person who smokes cigarettes has a habit of nicotine. If you stop smoking suddenly, the removal of nicotine from the body can cause withdrawal symptoms. That is why you should opt for nicotine replacement therapy. In this, one should opt for any other product containing nicotine, like gums, patches, nasal sprays, inhalers or lozenges, instead of cigarettes.
You should contact your physician regarding this, and they will suggest you a controlled dose of nicotine. Due to this, you will not notice cravings, irritability and anxiety. With time, a person can decrease the dependency on these nicotine products and live a healthy life. These products are highly effective and recommended for someone who is looking to give up smoking for a very long time.
- Support groups
Support groups are also a very effective way if you want to quit smoking. In these support groups, there are many people who have the same goal of quitting. They provide support, encouragement and make each other accountable for not smoking. The reason why you should join a support group is that it provides you with a safe place to talk.
Not everyone understands how difficult quitting can be. But in these support groups, you will find people who already have a foot in your shoe. They will provide you with various tips for coping with withdrawal symptoms and cravings.
- Behavioural therapy
In most cases, it is noticed that smoking of a person is related to some sort of patterns and behaviours. In behavioural therapy, the physician focuses on identifying those behaviours and triggers. After identifying this, the therapist is going to develop strategies to get over those behaviours and smoking.
It can be done individually or with a group as per your choice. These therapies include contingent management and motivational interviewing to change how smokers think about smoking and motivate a person to quit easily.
Managing your weight is very important not just for having a proper sexual life but also for living a healthy life. You can take the following steps to manage your weight and get over obesity-
- Monitoring caloric intake
If you are looking to manage your weight, the first step you should take is to count the calories you are consuming every day. It is very important because a calorie deficit is the only way to lose weight. No matter how clean you are eating, until your calories consumed are not below the calories your body requires, you will not lose weight. You can use a calorie tracking app or consult with a registered dietitian to know how you can monitor and control your calorie intake without starving or hungry.
- Balancing diet and exercise
One of the most important parts of weight management is to consume a balanced diet and include exercise in your day-to-day life. You should decrease your dependency on junk and packed food and instead start eating healthy and have a balanced diet.
Stress is a very big contributor to erectile dysfunction issues. Here are a few ways that can help you get rid of stress and erectile dysfunction eventually.
- Mindfulness meditation
Meditation is a very common practice that helps in reducing your stress, anxiety and depression. What you need to do is find a silent room and sit quietly. Now you should pay attention to the present moment and don’t focus on the external stimuli. Due to this, you will be able to observe your thoughts and emotions without being judgemental about them.
It will help you in lowering your cortisol and adrenaline levels in your body which promotes relaxation and reduce anxiety. The anxiety reduction will automatically mark an improvement in erectile dysfunction problems.
- Progressive muscle relaxation
In this method, you need to involve tensing and relaxing different muscles in your body. By this tensing and relaxing of the muscles, you will be able to release your physical tension. This helps in reducing your stress and anxiety, which marks a betterment in your erectile dysfunction problem also.
- Deep breathing exercises
Deep breathing is an exercise in which you need to take slow and deep breaths and exhale them slowly. With this exercise, you will notice s slowdown in your heart rate and blood pressure, which reduces your stress and anxiety. You must contact your physician to get proper guidance about deep breathing.
- Time management
Most males are not unable to manage their time properly, due to which a person is stressed most of the time. Due to this, a person is unable to organize their tasks and prioritize responsibilities. That is why to get over the stress of completing your task, you must make a daily planner and prioritize your tasks.
But there is a suggestion that you must set realistic goals and deadlines. If you set unrealistic goals, you will notice an increase in your stress levels.
5) Alternative and complementary therapies
The following are the alternative and complementary therapies that you can opt for when you are suffering from erectile dysfunction.
Acupuncture is an ancient Chinese technique that involves inserting thin needles into your body. These needles are inserted at specific points in your body where major blood vessels and muscles are present in the body. Acupuncture is going to increase the flow of energy in your body, which promotes healing, improves blood flow, balances hormones in the body and reduces stress and anxiety.
- Rationale and mechanism
According to studies, when the therapist is going to insert needles into your body, the release of nitric oxide will increase. This chemical is going to dilate the blood vessels, which improves the blood flow to your penis and improves your erectile dysfunction. For people who are suffering from stress and anxiety, acupuncture is going to reduce cortisol levels which will increase your endorphins. It promotes relaxation and reduces your stress levels.
- Research evidence
There are eight controlled but randomized trials performed on erectile dysfunction patients. The trial results show that acupuncture is going to improve erectile dysfunction in men. If mixed with herbal medicines, ED patients will get better results and are able to improve spinal cord injuries also.
- Safety and potential side effects
As far as safety is concerned, acupuncture is only performed with practitioners who license with sterile needles. But there are a few side effects that might appear in your body due to acupuncture-
- Pain and bruising
- Muscle twitching
- An emotional release like crying, laughing or feeling sad suddenly
Herbal remedies and supplements
Herbal remedies and supplements have been used for centuries now to treat erectile dysfunction and many other problems. Here are a few herbal remedies and supplements that you can use to get rid of erectile dysfunction problems.
It is an amino acid that is found naturally in the body. It is the amino acid that is converted into nitric oxide when required to dilate the blood vessels, which improves the symptoms of erectile dysfunction. But there are various reasons due to which the production of L-arginine is decreased in the body. For that, you can consume the L-arginine supplements combined with pycnogenol.
But you must consult your physician first about consuming these supplements. They will check whether the L-arginine in the body is low or not. After that, they will provide you with the prescription for the supplements.
Precautions & Side Effects
- The supplement is going to interact with blood pressure and nitrate medicines.
- The supplement can cause a dangerous drop in blood pressure which you must take care of.
- The supplements can cause stomach pain as a side effect.
- The supplement can also cause diarrhea and bloating issues.
It is a natural compound that a person gets from the bark of the Yohimbe tree. It helps in improving mild to moderate levels of ED but doesn’t help with severe levels. The effectiveness of Yohimbine is not proven yet, but many people have been using it for centuries. The Yohimbine is going to block the receptors that are responsible for preventing erection. Moreover, it also promotes the release of nitric oxide.
Precautions & side effects
- The supplements can cause nausea.
- You might notice dizziness and anxiety due to these supplements.
- This supplement interacts negatively with antidepressants and blood pressure medications. That is why you should not consume it together.
- You should not consume this supplement if you have liver or kidney problems.
DHEA is also produced naturally in the body by L-arginine, which plays a very important role in the production of testosterone. Now, people can also consume DHEA supplements if the body is unable to produce DHEA.
Precautions and Side Effects
- The supplements interact with blood thinners and insulin.
- You might notice acne and hair loss because of the supplement.
- The supplement can also lead to mood changes in your body.
- Ginkgo biloba
It is a Chinese medicine that males use to improve erectile dysfunction issues. This medicine is going to improve the blood flow in your body, due to which you will notice an improvement in ED issues. But like Yohimbine, there is no strong evidence that the herb works and shows great action.
Precautions and Side Effects
- Ginkgo interacts negatively with blood thinners and antidepressants.
- You might notice side effects like headache, dizziness and upset stomach because of the supplement.
Pelvic floor physical therapy
As discussed above, the pelvic floor muscles play a very important role in erectile dysfunction and the sexual life of a person. They are also known as pubococcygeus muscles which run from the pubic bone to the tailbone. The main task of these muscles is to support the bladder, prostate gland, rectum, etc.
- Role of pelvic floor muscles in erectile function
You should know that the pelvic muscles are the one that traps blood inside the penis to maintain the erection. When you gain an erection, these muscles will contract to compress the veins which are responsible for drawing blood outside the penis. In case your muscles are weak, you will face problems in achieving and maintaining an erection.
- Assessment and treatment by a specialized physical therapist
If you are facing problems in gaining and maintaining an erection, you must visit a specialized therapist. They are going to check your pelvic floor muscles and perform a digital rectal exam through a biofeedback machine. After the assessment, if they find that your muscles are weak, they will suggest exercises to improve your pelvic floor muscle strength.
- Home exercise program
The best way to provide strength to your pelvic floor muscles is to perform kegel exercises at home. Following are the steps you must take to perform the kegel exercise-
- First of all, you should identify those which are pelvic floor muscles. To do so, you can try to stop the urine flow in the middle of peeing. The muscles which are contracted in this case are kegel.
- Now you should empty your bladder before doing the exercise. If you practice kegel exercise with a full bladder, you might suffer from infections and complications in your bladder.
- Now the first step you must take is to contract your pelvic floor muscles. You should squeeze them for 5-10 seconds. Make sure that you don’t squeeze your buttocks or thigh muscles.
- After that, you should relax your muscles for 5-10 seconds. While relaxing, you should take deep breaths. You should repeat this exercise for 10-15 times, 3-4 times a day.
- But you should keep in mind that you increase the frequency slowly to see improvement and do it on a regular basis.
In the above part of the blog, we have studied what erectile dysfunction is and how you can get rid of the issue. But there are some prevention strategies also which help your body stay healthy and avoid erectile dysfunction.
1) Regular medical check-ups
If you don’t want erectile dysfunction to happen inside your body, it would be better to get regular medical check-ups done. As we know that there are several underlying issues due to which a person might suffer from erectile dysfunction. That is why we suggest you regularly get your body checked for diabetes, high blood pressure, cholesterol, etc., which can directly cause ED.
Apart from that, you should also get your testosterone levels checked on a regular basis. If you find that there is any problem that is in its initial phase, you must take steps to prevent and cure that issue as soon as possible before it turns into erectile dysfunction.
2) Maintaining a healthy lifestyle
Maintaining a healthy life is not just a permanent cure for erectile dysfunction issues but also helps people in preventing it from happening. A well-maintained and healthy lifestyle is going to keep your overall body fit and don’t let any major issues happen in your body. To maintain your lifestyle, you should take the following steps-
- First of all, you should add exercise to your day-to-day schedule. You should perform aerobics, weight training and kegel exercises on a regular basis to keep your body fit and sexually healthy.
- You should stop consuming junk food as much as possible and switch to a balanced diet. It should include fruits, fibres, whole grains, lean protein, and good fats in the body. It will reduce the risk of major complications like high blood pressure, cholesterol and diabetes.
- One of the most important parts of maintaining a healthy lifestyle is to get adequate sleep. A healthy sleep clock in your body is going to make sure that your body and internal gland function properly. Also, the hormone level in your body also stays normal in this case.
3) Open communication with partners
We all know that open communication in your life is very important. No matter if it is about your sexual needs or any other kind of relationship issues, you must openly communicate with your partner. This way, your partner will understand what you have in mind and vice versa. Open communication is going to help you address problems like stress, anxiety or performance-related problems. You will notice that due to open communication, you will notice an improvement in your sexual life also.
4) Seeking timely help for mental health issues
If we see the stats, then people tend to address physical issues more than mental health issues in their bodies. Most people ignore it easily, and some of them think that talking about this is taboo. If you detect a mental health issue at a very early age, you must contact a professional therapist. They will help you get over issues like depression and anxiety easily before it becomes a problem for your physical health or sexual life.
5) Limiting alcohol consumption
Alcohol consumption is a very serious problem that people have made a part of their lifestyle lately. It can cause erectile dysfunction, which is why you should stop consuming alcohol if you want to prevent erectile dysfunction from happening.
In case you are consuming alcohol on a regular basis, you should limit it to one to two drinks per day and then stop it eventually. It would be better for your sexual health and improve it.
Erectile Dysfunction and Relationships
We all know that the dynamics of a relationship can badly impact the sexual life of a person. In males, it can cause problems like erectile dysfunction, and in females, it can cause problems such as female sexual arousal disorder. If you are a male who is suffering from ED, you should always focus on improving your relationship to improve your situation. The following are the strategies that can help you overcome relationship problems and improve your sexual life.
1) Impact on self-esteem and intimacy
You should know that erectile dysfunction happens in the body of a person due to emotional problems also. You should know that men who have erectile dysfunction can experience various problems like embarrassment, low self-esteem, frustration and shame.
- Emotional challenges
Due to the emotional problems, we have discussed above, a person faces a lack of confidence. It will also decrease the sexual desire that one might have. If you are facing any such issue, you must talk to your partner properly. It will help you get over these emotions, and you will notice a rise in your sexual health.
- Impact on Partner’s Self-esteem
If a male is suffering from erectile dysfunction, then their partner will also experience low self-esteem. They start questioning their attractiveness, desirability and sexual appeal to their partner. In such a case, females should leave all these emotions behind and communicate with their partners. They should try to build intimacy slowly and figure out where the problem is.
2) Supporting a partner with erectile dysfunction
If you notice that your patient has erectile dysfunction issues, you must not feel that you are less in any way. Instead, you should talk to your partner and support them in this phase. It will help them improve their situation. To show support to your partner, you must follow these strategies-
- Encouraging open communication
First of all, you should make sure that you make your partner feel welcome to come to you and communicate. You should encourage them to talk to you and don’t judge them no matter what their feelings and concerns are. All you need to do is listen to them actively, try to understand them and provide empathy as much as possible. It will make them feel safe.
- Demonstrating empathy and understanding
Showing empathy is very important if your partner is suffering from erectile dysfunction. You should make them feel that erectile dysfunction is a common problem and it can be treated easily. You should make them feel that the erectile dysfunction issue is not a reflection of their masculinity, and they should not feel less of themselves.
- Participating in treatment and lifestyle changes
When you visit the physician, they are going to suggest treatment to the male. We suggest you be a part of their treatment. You should encourage them to actively be a part of the treatment. Also, if they need to make any lifestyle changes and improvements, you must also change with them. You both should eat healthily, exercise regularly and limit your alcohol consumption to mark an improvement in your sexual life.
3) Overcoming relationship challenges
Maintaining a healthy relationship can be very difficult, and it takes a lot of effort. There are many times when a couple faces problems in a relationship also. We suggest you take the following steps to overcome the challenges you are facing in your relationship.
- Emphasizing emotional intimacy
You should first know that having a great physical life and intimacy is very important, but emotional intimacy is equally important. It is important to spend quality time together, expressing affection in ways other than non-sexual, engaging in conversations, talking about the future, etc. That is why we suggest you emphasize properly on your emotional intimacy also.
- Exploring alternative ways of expressing love and affection
It is very important that you find different ways to express love and affection to your partner. We suggest you cuddle with your partner, hold hands, give massages to each other and be involved in casual physical touch other than sexual activity. It will keep the spark in your relationship alive.
- Rekindling romance and passion
You should introduce different ways to introduce romance and passion in your relationship to have an intimate relationship. Other than sex, you should try new things together and show gratitude to your partner. You should appreciate your partner and do something special for your partner. Plan a date night, weekend away, quiet evening, etc., to rekindle romance and passion.
Erectile dysfunction is now a common problem that is affecting millions of men globally. It can have a significant impact on the quality of life of man, relationships and self-esteem of a person. The problem can take a major toll on your physical and mental health and can become really serious with time. But one should keep in mind that early detection of the issue is really great for managing the condition easily. Moreover, early detection of the issue is also going to help you figure out if you have any major underlying health problem.
That is why you must contact your physician as soon as possible and seek their importance. Moreover, when you visit your physician, we suggest you not just depend on one line of treatment but on a holistic approach. It is important because there can be various reasons why ED is happening in your body, and this approach will address all the major reasons, which will provide you with better results. A common treatment should include medications/ injections with a complete change in lifestyle.
Even if you are looking to get surgery, you should change your lifestyle also. Such an approach will also help you improve your overall well-being. Most people think that talking about erectile dysfunction is taboo. There is a stigma around the condition, due to which a man is unable to open up honestly and talk about the issue. Due to this, a person will also notice a decline in their emotional and mental health. That is why we should break the stigma so that shame and isolation among men decrease.
If you are a patient of erectile dysfunction, you should know that mental and emotional health plays a very important role. Stress, depression and anxiety can contribute to the condition. That is why one should not just consult their physician but also a therapist if they have ED. Seeking professional treatments is going to help you manage your stress and anxiety better, which improves your ED faster.
- Yafi, F.A., et al. (2016). Erectile dysfunction. Nature Reviews. Disease Primers. 2, 16003. Retrieved from: Link
- Symptoms & Causes of Erectile Dysfunction. (2017, July). Retrieved from: Link
- Bronner, G. & Vodušek, D.B. (2011, November). Management of sexual dysfunction in Parkinson’s disease. Neurological Disorders. 4 (6), 375-383. Retrieved from: Link
- Treatment for Erectile Dysfunction. (2017, July). Retrieved from: Link
- Dhaliwal, A. & Gupta, M. (2022, May 20). PDE5 Inhibitors. StatPearls. Retrieved from: Link
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